On Monday, President Barack Obama signed executive orders effectively preventing the federal government as well as its many contracting agencies from discriminating against gay and transgender workers. According to The Associated Press, this change in federal contracting rules impacts about 24,000 companies with 28 million workers, or one-fifth of the U.S. workforce. Obama amended two executive orders to accomplish the workplace protections and align them with provisions in the Affordable Care Act prohibiting discrimination against transgendered people.

"It's not just about doing the right thing, it's also about attracting and retaining the best talent," Obama said at a signing ceremony from the White House East Room. While many federal contractors already have nondiscrimination policies for gay employees, the new orders will cover about 14 million workers whose states or employers have not enacted such policies, the AP reported.

The first executive order amended and signed by Obama originally prohibited federal contractors from discriminating based on race, religion, gender, or nationality in hiring. Established and signed by President Lyndon Johnson in 1965, President George W. Bush amended it in 2002 to add an exemption for religious groups. Now, Obama has added sexual orientation and gender identity to the list. Obama also revised a second executive order, which had been signed by President Richard Nixon in 1969 to prevent discrimination against federal workers based on race, religion, gender, nationality, age, or disability. President Bill Clinton added sexual orientation, and now Obama is seeking to protect gender identity.

The Labor Department is expected to carry out these orders, which should take effect by early next year, according to the AP. Some would argue protections already existed for transgender workers. In 2012, the American Civil Liberties Union notes, the U.S. Equal Employment Opportunity Commission (EEOC) found that "discrimination against a transgender individual because that person is transgender is ... discrimination 'based on ... sex,' and ... violates Title VII."  

In 2010, the Affordable Care Act banned sex discrimination in many health care facilities and programs. According to the National Center for Transgender Equality, it is illegal for health care providers receiving federal money to:

  • Refuse to admit or treat you
  • Subject you to intrusive and medically unnecessary examinations as a condition of treatment
  • Refuse to provide you services that they provide to other patients
  • Harass you or refuse to respond to harassment by staff or other patients
  • Refuse to provide counseling, medical advocacy or referrals, or other support services
  • Isolate you or deprive you of human contact, or limit your participation in social or recreational activities offered to others
  • Require you to participate in “conversion therapy” for the purpose of changing your gender identity
  • Harass, coerce, intimidate, or interfere with your ability to freely exercise your health care rights.

Despite the clarity of these provisions, only five states and the District of Columbia, according to RH Reality Check, have formally issued bulletins stating they will cover transition-related care as part of non-discriminatory practices: California, Colorado, Oregon, Vermont, and Connecticut. In most states, then, it is still questionable whether a transgender person will receive transition care under the Affordable Care Act.